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<br />ACC7RL? CERTIFICATE OF LIABILITY INSURANCE DA /DOIYYVV(
<br />_ 1211212/12/2018
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ios) must have ADDITIONAL INSURED provisions or he endorsed,
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,. certain policies may require an endorsement. A statement on
<br />PRODUCER
<br />'A"A ,
<br />NA
<br />Risk Management Department
<br />CommercialLines
<br />_.__.,_.___
<br />m ._.
<br />PHONE - - FAX
<br />(ail .No,.Bxfl. 866.448-8489 Lu �Nl 800-889-0021
<br />USI Insurance Services National, Inc.
<br />ADDRESS;
<br />Work Comp@trinetcorn
<br />2601 South Bayshore Drive, Suite 1600
<br />(
<br />IN81 WRERiS I,AFFORDING COVERAGE
<br />NAIIC
<br />Coconut Grove, FL 33133
<br />INsuReRA:
<br />ACE American Insurance Company
<br />—
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<br />22867
<br />INSURED
<br />a:
<br />TrlNet HR III, Inc.
<br />_INSURER
<br />INSURER C______
<br />L/C/F Sedaru, Inc. FKA ID Modeling, Inc,
<br />INSURER D:
<br />9000 Town Center Parkway
<br />INSURER E:
<br />Bradenton, FL 34202
<br />....... _... .._.._____�___�.,�.—
<br />C(nVFRAr.PR OFRTIFICATF KIHMRFR• 13717410 tHPIACROM MI lndnco. ce k.1—,
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILm TYPE OF INSURANCE !INSO POLICYNUMBER�mm MMIDDIr1'YYY MMIDDIYYYY LIMITS LV
<br />COMMERCIAL GENERAL LIABILITY I
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<br />EACH OCCURRENCE
<br />$
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<br />i IF_.I CLAIMS MADE LT.) OCCUR
<br />DAMAOE'TO"RENTED
<br />PREMISES Eeoccurrence _,
<br />MEO EXP (An oePeNo_l
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<br />PERSONAL &ADV INJURY v
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<br />LGEWL AGGREGATE UN IT APPLIES PER: i
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<br />L__� POLICY [ JECI' j LOC
<br />OTHER: .......i........1......-..
<br />GENERAL AGGREGATE
<br />PRODUCTS -00MP1)P AGO
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<br />AUTOMOBILE
<br />LIABILITY
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<br />Ea aBatleDI51NGLE LIWIT
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<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
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<br />OWNED # SCHEDULED
<br />AUTOS ONLY (AUTOS
<br />, HIRED NON -OWNED
<br />I AUTOS ONLY AUTOS ONLY
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<br />BODILY INJURY (Per awideno
<br />&
<br />PROPERTY DAMAGE
<br />Per accident
<br />S
<br />Is
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<br />I
<br />!
<br />(UMBRELLA LIAR OCCUR j
<br />EXCESS LIAB CLAIMS -MADE(
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<br />EACHOCOURRENCE
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<br />AGGREGATE
<br />S
<br />S
<br />DED RETENTIONS
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS` LIABILITY YIN
<br />ANYPROPRIETOR1PARTNER,EXECUTIVE
<br />OFPICERINIEMBEREXCLUDED4 IN NIA
<br />(ManaatotyblNH)
<br />li yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />WLR_C65449134
<br />7I1/20'IS
<br />7/112.019
<br />_
<br />R'� 0 H'
<br />x srATUTE Ea
<br />ST., EACH ACCIDENT
<br />i 5 2,000,000
<br />-
<br />E,L DISEASE EA EMPLOYEE
<br />)S $000.000
<br />E.L. DISEASE POLICY LIMIT
<br />j S 2.000.000
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<br />DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES(ACORD10 s I,�RLrI�cIMdrLi,potynFpace is requ�
<br />Workers Compensation is limited to worksite employee o r L. II/` fri7rL,t.0 In�j�ja.,,,,,.,,,(Vf(�1llii�+vvlJWW a co-em to ment contract with TriNDt HR Ill, Inc.
<br />v
<br />PRGE�, OF-4-0
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />Ross Annex (M-22
<br />Santa Ana CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />9e . 4
<br />name and logo are registered marks of ACORD ©1988.2015 ACORD CORPORATION. All rights reserved.
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